Fifteen million Americans use statin drugs to lower their cholesterol. But there are side effects to be aware of such as muscle aches or myalgias.

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A few weeks ago, I got together with a group of guys in the neighborhood for a run. We originally had grand ambitions to do this every week, even twice a week, but this was the first time we actually made it happen in a few months. I had my sights set on a particular runner, named Jon. He was the most athletic in the group and the fastest, despite being a couple of years older. I was planning to start off easy, then keep pace with him.

It was around 7 a.m. when the six of us started our run, and within 20 minutes my plan was going beautifully. Then I realized that Jon wasn’t only running more slowly than the entire group, but he appeared to be struggling, even wincing with each step. When I asked him about it at the end of our run, he described muscle aches throughout his body, especially in his legs and shoulder. He hadn’t been sick recently, and had no other flu-like symptoms. The only thing that had changed was the addition of a new medication to lower his cholesterol, a statin drug.

Statin medications have been around for a long time, and around 15 million Americans use them. Generally speaking, they’re pretty safe. There is, however, a real concern about muscle aches or myalgias. About 10 percent of people will develop these, and the pain usually occurs in the first month.

According to a new study published this month in JAMA, “musculoskeletal conditions…injuries and pain are more common among statin users.” An estimated one in 1,000 people who use statins develop myositis, an inflammation of the muscles that causes tenderness and fever. An even smaller number, one in every 10,000 people, develops a serious condition called rhabdomyolysis, a potentially deadly breakdown of muscle fibers that can damage the kidneys.

Weighing the risks and benefits of statin therapy can be tricky. Muscle pain may seem like a small price to pay when it comes to potentially decreasing your chances of heart disease, but it’s not an easy decision for Jon and millions of others who suffer with these body-wide pains.

Here is an action plan that might help:

Make sure the pain is due to the medications and not something else. If your doctor agrees, try a “statin holiday” for two weeks. See if you feel better. That will help confirm your suspicion. But remember: This is not the time to stop the medication altogether.

Try another statin medication. No one is entirely sure why statin drugs cause muscle pain, and another medication class may be better for you. Zetia or red yeast rice, for instance, may be good options. Ask your doctor what options are available.

You may want to cut back on your exercise routine. When I asked my cardiologist about this, he recommended longer, slower runs rather than the rabbit-like pace Jon favors.

One important caveat: Don’t use over-the-counter medications life ibuprofen or Tylenol. They don’t offer much relief and may interfere with the pathways that allow statin drugs to lower cholesterol in the first place.

Coenzyme Q10, which is made naturally by the body but available as a supplement, may help. The studies on this are limited, but research suggests it may reduce some of the side effects of statin drugs.

Some people are more likely than others to develop these problems. Older patients, for instance, and those with a previous muscle problem are most at risk. An existing condition with the liver or kidneys increases your risk, as does an underactive thyroid. Antibiotics and antifungals can also interact with statin medication.

Over the last few weeks, Jon has been executing the action plan under the watchful eye of his doctor. In the meantime, I am taking advantage of the opportunity to be neighborhood champ… if only for a few weeks.

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